Abstract

Section A reviewed 18 empirical behavioural studies on empathy and mental state inference (MSI) skills in those meeting Borderline Personality Disorder (BPD) criteria. The review was situated within Mentalization theory (MBT), which posits a central link between such skills and complex needs presentation. Firm conclusions about BPD mentalization skills are difficult as deficits, enhanced abilities and no differences from non-patients are reported. None of the reviewed papers stimulated attachment system arousal, as warranted by mentalization theory. Economic game research was highlighted as offering value in assessing self-directed mentalization, an under-researched area.Section B sought to test MBT and other model’s claim that empathy and Mental State inference (MSI) skills are differentially degraded in Borderline Personality Disorder (BPD). 27 people meeting BPD criteria and a matched non-patient group had empathy assessed with the Reading the Mind in the Eyes Task and MSI assessed with a modified economic game. This was done before and after a novel attachment system intervention. Empathy skills were less accurate in the BPD group. Other findings including game behaviour, fairness ratings and a social cue selective prioritisation in non-patients only are discussed. The theoretical links and suggestions for clinical innovation and research development are provided.